There are too many senior managers in the HSE and significant anomalies in their deployment, writes Martin Wall, Industry Correspondent
ABOUT 16 per cent of the 110,000 posts in the Health Service Executive (HSE) are considered to be administrative grades.
This figure and the significant rise over recent years in the number of staff designated at grade eight levels - the lowest rung of the senior management ranks - has led to frequent charges by the Opposition that the HSE is a "bloated bureaucracy".
The new administrative staff assessment programme commissioned by the HSE finds that the number of clerical, administrative and managerial personnel is not out of line with similar health service organisations in Northern Ireland, Scotland and Wales.
However, it warns that there are too many senior managers and there are significant variances and anomalies in how these are deployed around the State.
The assessment programme also says there is a "lack of consistency in the evaluation, creation and population of managerial positions within the HSE".
In the local health office for west Cork, which serves a population of 53,565, there are 84 administrative personnel, while in Dublin southwest, which has a catchment population of 147,000, there are 74 administrative staff.
The assessment programme maintains its initial review "indicates that there has not been an effective and coherent multidisciplinary national manpower planning system within the health service".
Senior HSE sources argue that many of the problems identified in the assessments were legacy issues that existed from before the establishment of the centralised health authority and it is now moving to deal with the issues.
On foot of the assessment programme - carried out by both an external consultancy firm, Empower Solutions, and internally by HSE management - the organisation has set out a number of steps to be taken. These include an early retirement programme, which would target up to 1,000 posts; an analysis of staffing in the former health board headquarters; and an independent assessment of current and proposed senior management positions.
The most controversial of the proposals is the early retirement scheme, which the assessment report says the HSE has been seeking in contacts with the Departments of Health and Finance for the last nine months.
Minister for Health Mary Harney has already publicly accepted that a redundancy programme may be needed, although highly placed sources have said the Department of Health is baulking at the scale of the proposed scheme.
The HSE has sought a two-part retirement scheme that would initially target 200 senior management posts (at grade eight or above), to be followed by a second wave of 800 redundancies at lower-level grades.
The HSE is hoping that it will receive Government approval to begin work on the senior management scheme by early June. However, there have been signals in recent weeks that the Department of Health has problems with the early-retirement programme for the lower-grade administrative staff, whom it would prefer to see redeployed.
One of the reasons the Government shied away from a rationalisation plan when the 11 former health boards were amalgamated into the HSE was that it feared civil servants facing being moved out of Dublin under the decentralisation programme would seek similar arrangements.
Such fears may still exist in the thinking of the two departments.
Regardless of the early retirement plan, the assessment report says that the HSE is to carry out a new evaluation of top-level senior management posts.
"The external analysis states that the HSE had more managers than comparator organisations. The internal analysis found there was a significant variance in management responsibilities in the different directorates. This analysis highlights a lack of consistency in the evaluation, creation and population of management jobs within the HSE."
The report says that every post at local health manager or above needs to be independently assessed. "Where a post is found not to be at the appropriate level, the post-holder can remain on a personalised basis in the position until an appropriate position becomes available. Alternatively the post holder can be referred to mediation for possible exit," the report states.
It also says that an evaluation should get under way in the former health board headquarters to determine if there are people or units whose roles have changed and to assess the potential for redeployment.
"In June 2005, before the health board CEOs departed, all HSE staff were repointed to relevant senior managers in their area.
"However, most of the functions being managed in those locations in 2005 are still being managed there today, despite the creation of corporate structures," the report says.